Tara Beth Luellen, MA, LPA

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

4097 Issued in NC

Practice address

5838 Six Forks Rd
Suite 200
Raleigh, NC 27609-3885

Phone

(919) 785-9944

Fax

(919) 785-9992

NPI assigned

Feb 28, 2011

Last updated

Apr 3, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Miss Tara Beth Pool Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Neuropsychology Consultants, PA

  • Clinical Psychologist
  • Raleigh, NC
  • NPI 1518158757
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1298851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333411200000",
    "number": "1659678647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 ANCIENT OAKS DR",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275407986",
            "telephone_number": "573-888-7598",
            "fax_number": "919-346-1011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5838 SIX FORKS RD",
            "address_2": "SUITE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276093885",
            "telephone_number": "919-785-9944",
            "fax_number": "919-785-9992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUELLEN",
        "first_name": "TARA",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "MA, LPA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-28",
        "last_updated": "2012-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "0935",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "4097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "POOL",
            "middle_name": "BETH",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jo-Anne Vicario Ludwig, M.A., LPC, NCC, LCAS
• Johanna Ludwig, OTR/L
• Warren W Ludwig, PHD
• John Francis Lue Jr., M.D.
• Andrea Lueken, OTR/L
• Richard Scott Luetgenau, MSW, LCSWA
• Luis Gamboa DMD PC
• Luis Marcano - Counseling and Consultation Services, PLLC
• Luis Miguel Gonzalez DDS PLLC (32 Dental)
• Lawrence Linyea Luk, PA-C

• Clinical Psychologist in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.